先天性心脏病继发感染性心内膜炎的外科治疗  

SURGICAL TREATMENT OF INFECTIVE ENDOCARDITIS SECONDARY TO CONGENITAL HEART DISEASE

作　　者：陈凯明[1] 钟焕清[1] 黄志辉[1] 钟志敏[1] 陈景伟[1] 赖锋华[1] 许发珍[1] 

机构地区：[1]高州市人民医院,广东高州525200

出　　处：《现代医院》2010年第2期13-15,共3页Modern Hospitals

摘　　要：目的总结先天性心脏病继发感染性心内膜炎的外科治疗经验。方法手术治疗先天性心脏病合并感染性心内膜炎65例,手术原则是清除感染灶,矫治心脏畸形和恢复瓣膜功能,行室间隔缺损修补52例,动脉导管直视缝合8例,主动脉窦瘤修补2例,法洛四联症根治3例,同期行二尖瓣成形2例,三尖瓣成形12例,肺动脉瓣成形5例,二尖瓣置换2例,主动脉瓣置换3例,三尖瓣置换1例,二尖瓣主动脉瓣置换2例,主动脉根部置换1例。结果1例急诊行法洛四联症根治术后并发低心排综合征死亡;其余患者均痊愈出院。随访60例,随访6个月～10年,无1例死亡及心内膜炎复发。结论先天性心脏病继发感染性心内膜炎者正确选择手术时机及有效的抗生素是提高治愈率的关键。[ Abstract] Objective To retrospectively review the clinical experience of surgical treatment of infective en- docarditis secondary to congenital heart disease. Methods Operations were underwent in 65 patients with infective endocarditis secondary to congenital heart disease. Principles of operation included clearance of focus of infection, correction of cardiac defects and recovery of valvular functions. Ventricular septal defect repair, ductus arteriosus suture, aneurysm of aortic sinus repair, total correction of tetralogy of FaUot were performed in 52,8,2,3 patients, respectively. While simultaneous mitral valve annuloplasty （ 2 patients） , tricuspic valve armuloplasty （ 12 patients） , pulmonary valve annuloplasty （ 5 patients） , mitral valve replacement （2 patients）, aortic valve replacement （ 3 patients） , tricus- pic valve replacement（ 1 patients）, double mitral valve and aortic valve replacement （2 patients）, and aortic root replacement （ 1 patients） were performed. Results 1 patient who underwent emergent total correction of tetralogy of Fallot died of low cardiac output syndrome, the rest of patients were discharged from hospital smoothly. 60 patients had completed follow - up with no death or recurrence of endocarditis. The follow - up period ranged from 6 months to 10 years. Conclusion Corrective timing of surgery and effective antibiotics are key to the successful treatment of infective endocarditis secondary to congenital heart disease.

关 键 词：先天性心脏病 感染性心内膜炎 外科治疗 

分 类 号：R654.2[医药卫生—外科学] R541.1[医药卫生—临床医学]